Markets, Depots and Sales Tables: The Women's Institute's Rural Retailing

In 1917 the Coventry Evening Telegraph noted that the problems of ‘surplus garden produce’ had arisen and that ‘smallholders were being encouraged to group together in order to bring their supplies in quantity to market. Women’s Institutes have been formed, and these arrange for the opening of a market for a certain number of hours one day a week’. WIs, which had begun being formed under the auspices of the Agricultural Organisation Society from 1915 could be seen to be one of the earliest examples of Farmers Markets. These rural women were to improve the food supply in wartime when there was a food crisis; shortages, queues, price rises and in 1918 the introduction of rationing. The WIs encouraged food saving and preservation their markets enabled small holders, cottage gardeners and allotment holders to find a financial non- exploitive outlet for their produce. Markets and retail outlets developed in a number of towns or even cities in rural areas: Worcester, Leamington Spa and Lichfield and in post-war Britain depot trading centres were set up in some county towns Maidstone in Kent in 1919, Winchester in 1920. Between them they provided rural women with a retail space initially for their garden produce and then in time for the preserves, baking and craftwork. Jam, cakes, toys, knitted toys and garments even a wedding trousseau were ordered or sold through these retail outlets. The Markets were not restricted to WI members and often sold work produced by small­holders, the disabled and ex-servicemen. Membership required buying at least one share; as they were a co-operative venture there was a limit on the number of shares it was possible to purchase. Sales tables at some monthly WI meeting provided yet another retail outlet for rural women. This paper will explore the significance of these retail opportunities to rural women: as a chance to earn much needed cash, in placing a value on domestic labour and as an indication that when looking at rural women’s lives, in first half of the twentieth century, divisions between being consumers and producers of food and domestic products may be more fluid than it is something assumed.

Healthcare Staffs’ Experiences and Perceptions of Caring for People with Dementia in the Acute Setting: Qualitative Evidence Synthesis

Background Dementia is a global issue, with increasing prevalence rates impacting on health services internationally. People with dementia are frequently admitted to hospital, an environment that may not be suited to their needs. While many initiatives have been developed to improve their care in the acute setting, there is a lack of cohesive understanding of how staff experience and perceive the care they give to people with dementia in the acute setting. Objectives The aim of this qualitative synthesis was to explore health care staffs’ experiences and perceptions of caring for people with dementia in the acute setting. Qualitative synthesis can bring together isolated findings in a meaningful way that can inform policy development. Settings A screening process, using inclusion/exclusion criteria, identified qualitative studies that focused on health care staff caring for people with dementia in acute settings. Participants Twelve reports of nine studies were included for synthesis. Data extraction was conducted on each report by two researchers. Methods Framework synthesis was employed using VIPS framework, using Values, Individualised, Perspective and Social and psychological as concepts to guide synthesis. The VIPS framework has previously been used for exploring approaches to caring for people with dementia. Quality appraisal was conducted using Critical Appraisal Skills Programme (CASP) and NVivo facilitated sensitivity analysis to ensure confidence in the findings. Results Key themes, derived from VIPS, included a number of specific subthemes that examined: infrastructure and care pathways, person-centred approaches to care, how the person interacts with their environment and other patients, and family involvement in care decisions. The synthesis identified barriers to appropriate care for the person with dementia. These include ineffective pathways of care, unsuitable environments, inadequate resources and staffing levels and lack of emphasis on education and training for staff caring for people with dementia. Conclusions This review has identified key issues in the care of people with dementia in the acute setting: improving pathways of care, creating suitable environments, addressing resources and staffing levels and placing emphasis on the education for staff caring for people with dementia. Recommendations are made for practice consideration, policy development and future research. Leadership is required to instil the values needed to care for this client group in an effective and personcentred way. Qualitative evidence synthesis can inform policy and in this case, recommends VIPS as a suitable framework for guiding decisions around care for people with dementia in acute settings.